Index Patient 1
第一类病人
1. Clinicians should offer apalutamide or enzalutamide with continued androgen deprivation to patients with non-metastatic CRPC at high risk for developing metastatic disease. (Standard; Evidence Level Grade A)
1. 对于具有高危转移倾向的非转移性CRPC患者，推荐阿帕鲁胺或恩杂鲁胺以维持去势治疗（标准；证据水平 A）。
2. Clinicians may recommend observation with continued androgen deprivation to patients with non-metastatic CRPC at high risk for developing metastatic disease who do not want or cannot have one of the standard therapies. (Recommendation; Evidence Level Grade C)
2. 对于具有高危转移倾向的非转移性CRPC患者，在患者不愿或不能接受标准治疗的情况下，推荐采用观察加持续性去势疗法（推荐；证据水平C）。
3. Clinicians may offer treatment with a second-generation androgen synthesis inhibitor (i.e. abiraterone plus prednisone) to select patients with non-metastatic CRPC at high risk for developing metastatic disease who do not want or cannot have one of the standard therapies and are unwilling to accept observation. (Option; Evidence Level Grade C)
3. 对于具有高危转移倾向的非转移性CRPC患者，在患者不愿或不能接受标准去势疗法且不想接受观察疗法的情况下，可有选择地推荐使用第二代合成雄激素阻断剂（如阿比特龙加泼尼松）治疗（可选；证据水平C）。
4. Clinicians should not offer systemic chemotherapy or immunotherapy to patients with non-metastatic CRPC outside the context of a clinical trial. (Recommendation; Evidence Level Grade C).
4. 对于非转移性CRPC，除外临床试验，不推荐采用化疗或免疫疗法（推荐；证据水平C）。
Index Patient 2
第二类病人
5. Clinicians should offer abiraterone plus prednisone, enzalutamide, docetaxel, or sipuleucel-T to patients with asymptomatic or minimally symptomatic mCRPC with good performance status and no prior docetaxel chemotherapy. (Standard; Evidence Level Grade A [abiraterone plus prednisone and enzalutamide] /B [docetaxel and sipuleucel-T])
5. 对于无症状或症状轻微的mCRPC患者，在身体状况良好且未接受过多西他赛化疗的情况下，推荐使用阿比特龙加泼尼松、恩杂鲁胺、多西他赛或sipuleucel-T治疗 （标准; 证据水平 A [阿比特龙加泼尼松，恩杂鲁胺] / B [多西他赛，sipuleucel-T]）。
6. Clinicians may offer first- generation anti-androgen therapy, ketoconazole plus steroid or observation to patients with asymptomatic or minimally symptomatic mCRPC with good performance status and no prior docetaxel chemotherapy who do not want or cannot have one of the standard therapies. (Option; Evidence Level Grade C)
6. 对于无症状或症状轻微的mCRPC患者，在身体状况良好且未接受过多西他赛化疗的情况下，当患者不愿或不能接受标准的去势治疗时，推荐采用第一代抗雄激素疗法，如酮康唑加类固醇激素或观察疗法。 （可选; 证据水平C）。
Index Patient 3
第三类病人
7. Clinicians should offer abiraterone plus prednisone, enzalutamide or docetaxel to patients with symptomatic, mCRPC with good performance status and no prior docetaxel chemotherapy. (Standard; Evidence Level Grade A [abiraterone plus prednisone and enzalutamide] / B [docetaxel])
7. 对于有转移症状的mCRPC患者，在在身体状况良好且未接受过多西他赛化疗的情况下，推荐使用阿比特龙加泼尼松，恩杂鲁胺或多西他赛治疗（标准; 证据水平 A [阿比特龙加泼尼松，恩杂鲁胺 / B [多西他赛]）。
8. Clinicians may offer ketoconazole plus steroid, mitoxantrone or radionuclide therapy to patients with symptomatic, mCRPC with good performance status and no prior docetaxel chemotherapy who do not want or cannot have one of the standard therapies. (Option; Evidence Level Grade C [ketoconazole and radionuclide therapy] / B [mitoxantrone])
8. 对于有转移症状的mCRPC患者，在在身体状况良好且未接受过多西他赛化疗的情况下，在患者不愿或不能接受标准去势疗法的情况下，推荐使用酮康唑加类固醇激素、米妥蒽醌或放射性核素治疗（可选；证据水平 C [酮康唑，放射性核素] / B [米妥蒽醌]）。
9. Clinicians should offer radium-223 to patients with symptoms from bony metastases from mCRPC with good performance status and no prior docetaxel chemotherapy and without known visceral disease. (Standard; Evidence Level Grade B)
9. 对于合并骨转移症状的mCRPC患者，在身体状况良好、没有已知的内脏转移且没有接受过多西他赛化疗的情况下，推荐使用镭-223治疗（标准; 证据水平B）。
10. Clinicians should not offer treatment with either estramustine or sipuleucel-T to patients with symptomatic, mCRPC with good performance status and no prior docetaxel chemotherapy. (Recommendation; Evidence Level Grade C)
10. 对于有转移症状的mCRPC患者，在身体状况良好且没有接受过多西他赛化疗的情况下，不推荐使用雌二醇氮芥或sipuleucel-T治疗（推荐；证据水平C）。
Index Patient 4
第四类病人
11. Clinicians may offer treatment with abiraterone plus prednisone or enzalutamide to patients with symptomatic, mCRPC with poor performance status and no prior docetaxel chemotherapy. (Option; Evidence Level Grade C)
11. 对于有转移症状的mCRPC患者，在身体状况不佳且没有接受过多西他赛化疗的情况下，推荐使用阿比特龙加泼尼松或恩杂鲁胺治疗（可选；证据水平C）。
12. Clinicians may offer treatment with ketoconazole plus steroid or radionuclide therapy to patients with symptomatic, mCRPC with poor performance status and no prior docetaxel chemotherapy who are unable or unwilling to receive abiraterone plus prednisone or enzalutamide. (Option; Evidence Level Grade C)
12. 对于有转移症状的mCRPC患者，在全身状况不佳且没有接受过多西他赛化疗的情况，当患者不能或不愿接受阿比特龙加强的松或恩杂鲁胺治疗时，推荐使用酮康唑加类固醇激素或放射性核素治疗（可选；证据水平 C）。
13. Clinicians may offer docetaxel or mitoxantrone chemotherapy to patients with symptomatic mCRPC with poor performance status and no prior docetaxel chemotherapy in select cases, specifically when the performance status is directly related to the cancer. (Expert Opinion)
13. 对于有转移症状的mCRPC患者，在患者身体状况不佳且没有接受过多西他赛化疗的情况下，针对某些特殊病例，尤其是当身体状况不佳的原因与前列腺癌直接相关时，可使用多西他赛或米妥蒽醌化疗（专家意见）。
14. Clinicians may offer radium-223 to patients with symptoms from bony metastases from mCRPC with poor performance status and no prior docetaxel chemotherapy and without known visceral disease in select cases, specifically when the performance status is directly related to symptoms related to bone metastases. (Expert Opinion)
14. 对于有骨转移症状的mCRPC患者，在患者身体状况不佳但没有已知的内脏病变且没有接受过多西他赛化疗的情况下，针对某些特殊病例，尤其是当身体状况不佳的原因与前列腺癌骨转移直接相关时，可使用镭-223治疗（专家意见）。
15. Clinicians should not offer sipuleucel-T to patients with symptomatic, mCRPC with poor performance status and no prior docetaxel chemotherapy. (Recommendation; Evidence Level Grade C)
15. 对于有转移症状且身体状况不佳的mCRPC患者，在没有接受过多西他赛化疗的情况下，不推荐采用sipuleucel-T免疫疗法（推荐；证据水平C）。
Index Patient 5
第五类病人
16. Clinicians should offer treatment with abiraterone plus prednisone, cabazitaxel or enzalutamide to patients with mCRPC with good performance status who received prior docetaxel chemotherapy. If the patient received abiraterone plus prednisone prior to docetaxel chemotherapy, they should be offered cabazitaxel or enzalutamide. (Standard; Evidence Level Grade A [abiraterone plus prednisone and enzalutamide] / B [cabazitaxel])
16. 对于接受过多西他赛化疗的mCRPC患者，在身体状况良好的情况下，推荐使用阿比特龙加泼尼松、卡巴他赛或恩杂鲁胺治疗。如果在接受多西他赛化疗前使用过阿比特龙加泼尼松，推荐使用卡巴他赛或恩杂鲁胺（标准；证据水平A[阿比特龙加泼尼松，恩杂鲁胺] / B[卡巴他赛]）。
17. Clinicians may offer ketoconazole plus steroid to patients with mCRPC with good performance status who received prior docetaxel if abiraterone plus prednisone, cabazitaxel or enzalutamide is unavailable. (Option; Evidence Level Grade C)
17. 对于接受过多西他赛化疗的mCRPC患者，在身体状况良好的情况下，如果不能提供阿比特龙加类固醇激素、卡巴他赛或恩杂鲁胺治疗，推荐使用酮康唑加类固醇激素激素治疗（可选；证据水平C）。
18. Clinicians may offer retreatment with docetaxel to patients with mCRPC with good performance status who were benefitting at the time of discontinuation (due to reversible side effects) of docetaxel chemotherapy. (Option; Evidence Level Grade C)
18. 对于曾经从多西他赛化疗中获益，但是由于可逆性副作用而中断过治疗的mCRPC患者，在身体状况良好的情况，推荐重复应用多西他赛化疗（可选；证据水平C）。
19. Clinicians should offer radium-223 to patients with symptoms from bony metastases from mCRPC with good performance status who received prior docetaxel chemotherapy and without known visceral disease. (Standard; Evidence Level Grade B)
19. 对于曾接受过多西他赛化疗的有骨转移症状的mCRPC患者，在身体状况良好且没有已知的内脏病变的情况下，推荐使用镭-223治疗（标准；证据水平B）。
Index Patient 6
第六类病人
20. Clinicians should offer palliative care to patients with mCRPC with poor performance status who received prior docetaxel chemotherapy. Alternatively, for selected patients, clinicians may offer treatment with abiraterone plus prednisone, enzalutamide, ketoconazole plus steroid or radionuclide therapy. (Expert Opinion)
20. 对于曾经接受过多西他赛化疗且身体状况不良的mCRPC患者，推荐姑息疗法。针对某些特殊病例，可有选择地使用阿比特龙加泼尼松、恩杂鲁胺、酮康唑加类固醇激素或放射性核素治疗（专家意见）。
21. Clinicians should not offer systemic chemotherapy or immunotherapy to patients with mCRPC with poor performance status who received prior docetaxel chemotherapy. (Expert Opinion)
21. 对于曾接受过多西他赛化疗且身体状况不佳的mCRPC患者，不推荐采用系统性化疗或免疫治疗（专家意见）。
Bone Health
骨健康
22. Clinicians should offer preventative treatment (e.g., supplemental calcium, vitamin D) for fractures and skeletal related events to CRPC patients. (Recommendation; Evidence Level Grade C)
22. 对于合并骨折或其它骨相关事件的CRPC患者，推荐预防性补充钙剂及维生素D（推荐；证据水平C）。
23. Clinicians may choose either denosumab or zoledronic acid when selecting a preventative treatment for skeletal related events for mCRPC patients with bony metastases. (Option; Evidence Level Grade C)
23. 对于有骨转移的mCRPC患者，为预防骨相关事件的发生，可选择使用地诺单抗或唑来膦酸治疗（可选；证据水平C）。
方式一：
